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Whole brain radiation therapy (WBRT) has been the standard care for the majority of patients with brain metastasis. However, the outcome of these patients has been dismal due to both local and systemic failure. Stereotactic radiosurgery using either linac or Gamma Knife (GK) has been investigated in an attempt to improve patientÕs outcome. In this study, the researchers reported a three-arm prospective randomized clinical trial comparing GK alone, WBRT alone or both in terms of local control or brain disease and overall survival.

The occurrence of new brain lesions was lower in the two arms receiving WBRT.

Author's Conclusions:

In this study, radiosurgery improved local control of metastases in the brain. However, better local control did not translate into survival advantage in patients with 3 or less brain metastases. It would be very interesting to revisit this strategy in the selected group of patients who have brain metastases but with control of their systemic disease.